Early Interventions Effective in Reducing Psychosis Duration in Military Personnel

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These data have implications for the efficacy of the US military healthcare system as a whole in treating psychosis in service members.
These data have implications for the efficacy of the US military healthcare system as a whole in treating psychosis in service members.

The Naval Medical Center San Diego's Psychiatric Transition Program (NMCSD PTP) was effective in reducing the duration of untreated psychosis (DUP) for military service members experiencing first-episode psychosis, according to results published in Early Intervention in Psychiatry. These data have implications for the efficacy of the US military healthcare system as a whole in treating psychosis in service members.

Study participants (n=69) were active duty service members admitted to NMCSD PTP with diagnoses of schizophreniform disorder (13.04%), schizophrenia (43.48%), schizoaffective disorder (8.70%), other specific schizophreniform disorder (30.43%), or brief psychotic disorder (4.35%). Psychosis was characterized using the Positive and Negative Syndrome Scale, applied retrospectively to "case notes and collateral information" available in the military records of each patient. Military service members were hypothesized to receive early intervention after the emergence of psychosis symptoms compared with the general public because of the specific and coordinated nature of military health services.

The mean duration from first emergence of positive psychotic symptoms to initiation of scheduled (non-PRN) neuroleptic medication was 37.20 days (median, 4; standard deviation [SD], 105.25). The mean DUP before administration of nonscheduled (PRN) neuroleptic medications was 21.15 days (median, 2 days; SD, 62.14 days). The most frequent DUP value for either treatment mode was between 0 and 2 days, and 58.11% of study participants had 6 or fewer days of DUP. Investigators noted a "skewed" data distribution, with a small proportion of subjects with "prolonged DUP" elevating the mean duration. Results overall suggested a short DUP for military service personnel admitted to the NMSCD program.

These data support the strength of the NMCSD PTP, specifically in treating first-episode psychosis in military personnel, and may have implications for military treatment programs in general. Further studies may be necessary to confirm this outcome, given the small sample size and specific study site associated with these results.

Reference

Hann MC, Caporaso E, Loeffler G, et al. Early interventions in a US military FIRST episode psychosis program [published online July 3, 2018]. Early Interv Psychiatry. doi: 10.1111/eip.12709

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